Learning on the Job: Cher Smith

Curbs, uneven roads, gravel, mud and grass…negotiating life from a wheelchair is not easy. But with a few new skills, can come unexpected rewards.

“It seems incredible that you would just give someone a wheelchair and expect them to be able to use it,” says Cher Smith, Occupational Therapist at the Nova Scotia Rehabilitation Centre, in Halifax. “There is no other piece of $6000 medical equipment that we would just give to someone without training them on how to use it first.”

Enter the Wheelchair Skills Program, established by Dr. Lee Kirby, Professor in Dalhousie Medical School's Division of Physical Medicine and Rehabilitation, and a physician at the Nova Scotia Rehabilitation Hospital of Capital Health. When Cher joined as a team member, - after experience at the Children’s Centre in Halifax, then with people with amputations and finally the speciality seating and mobility clinic – her work became her passion.

“If the day ever comes when I don’t learn something new, I would be disappointed,” grinned Cher. “I would have to find a new job!”

Cher Smith (pictured left) with a group of OTs and OTAs teaching the "brick trick" for wheelies during a wheelchair skills training workshop

With projects funded in part by the Rick Hansen Institute, the Wheelchair Skills Program is grounded in evidenced-based research and best practices, and teaches wheelchair users and caregivers how to use manual and powered chairs properly. The program is offered in centres across Canada and is as a free, online resource for researchers and clinicians around the world.

This work has led Cher to travel and teach wheelchair skills in Bosnia (often known as the "City of Wheelchairs," Sarajevo, Bosnia and Herzegovina, has a disproportionate share of injured veterans, civilian land mine survivors and other persons with disabilities); and Tanzania, and she will soon visit Sri Lanka.

Her ‘students’ and their environments, she feels, teach her more than she imparts to them, including how people in wheelchairs can be perceived in other cultures – and an appreciation of how far we have progressed here in Canada.

“It was explained to me that in Swahili, all words fit into a categorical hierarchy with men and women at the top, followed by animals, and then plants and objects. The word for people with disabilities is in the lowest category of words.

“In Tanzania, they use three-wheeled and four-wheeled all-terrain wheelchairs which are better from a stability and maneuverability perspective. But the rule of thumb is that if the chair is too technologically complex to be repaired at a regular bike shop, then it’s as good as useless. “

One day, she hopes all countries will meet the World Health Organization’s standards for wheelchair provision and skills training. And, with a number of published papers under her belt, Cher says that her goal is to improve the care provided to clients by standardizing and streamlining the way wheelchair skills are taught – to users, caregivers as well as clinical professionals.Cher has come to see the world through her professional eyes and be in action advocating for accessibility in schools, and volunteering with wheelchair basketball. Through her travels, she has learned that in some parts of the world there are no wheelchairs yet a few hundred kilometers away, world-leading practices.

Her team finds that the skills they teach endure – “like learning to ride a bike, rather than strength training where you lose the muscle if you don’t use it” – and contribute to long term physical health. They also bring positive psychological benefits.

“Acquiring these skills makes wheelchair users more confident in themselves,” she concludes. “They feel able to go more places, be more active and try new things.”

For Cher, helping to move a life forward is the most rewarding thing of all.

“I thought it was fantastic to see what (the Wheelchair Research Team is) doing in terms of taking the issues about accessibility and mobility and wheelchairs and compressing them into an environment where you can understand the risks, the skills and the opportunities. What I love about what they’re doing is that they are actually disseminating that information. It is being widely utilized and picked up all around the world. … this kind of knowledge will help so many people and help them to be safe and skilled and effective; to be able to get around.”